Ferry Crossing Laguna de Arenal in Costa Rica
Ferry Crossing Laguna de Arenal in Costa Rica
Ferry Crossing Laguna de Arenal in Costa Rica

17 Expats Talk about Health Insurance and Healthcare in Costa Rica

By Joshua Wood, LPC

Last updated on Nov 27, 2021

Summary: Expats and global nomads in Costa Rica share their experiences with health insurance, healthcare in Costa Rica, local hospitals and specialists, quality of medical care and more.

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How are healthcare services Costa Rica?

When we asked expats and global nomads about the quality of medical care in Costa Rica, they replied:

"To use the socialized medical system in the area, you do not need to be a resident of Costa Rica (Residente). The hospital will accept all patients. It is not a large hospital and some procedures will be referred to either the closest national care hospital or one of the private hospitals in the Central Valley. However, there are many private care physicians in the area who will treat you and/or make referrals to more specialized care in other parts of the country. The local hospital has an emergency center," remarked another expat living in Quepos .

"In Costa Rica, you must be a resident of the country to qualify for CAJA also know as the national socialized medicine. Additionally, this is not an option but a requirement of your residency here. The monthly fee is calculated based on your income. The local clinic also known as EBAIS is centrally located. If you are in the area, familiarize yourself with it's location. If you are not a resident, there are several private care physicians in the area and they are well educated and professional. If you do not speak Spanish, there are many that are bilingual. I know of at least one that has a 24 hour facility for emergencies. Additionally, specialists from the Central Valley visit these private care facilities on a monthly basis so if you need specialized care, it is available. At present, a general office visit in a private care facility is $40-$45," said one expat living in Playa Jaco.

"If you're a resident you pretty much have to enroll in the Caja, the public health system, and if you aren't, you can't. So there's that. Whether or not you enroll in the Caja, if you have the funds, private insurance is nice. INS, the state insurance company, sells a pretty good policy for not too much money, and (ahem) it's darn near customary not to mention pre-existing conditions on the application. After a year or so INS doesn't care, and it does pay. Blue Cross and others have now entered the market, but I doubt they're as lax as INS. Of course, you can always pay out-of-pocket for private at prices about a third of US prices, but even a third adds up. Me, I'm only in the Caja now, since I let my INS policy lapse, but that's because I'm poor. People of some affluence usually do both--private for ease and comfort, public as a backup. Oh, in the Caja plan on speaking Spanish. Most Caja docs will know a little English and a few will be fluent, but the system operates in Spanish and you can't count on anyone speaking English. In the private system almost everybody speaks English," mentioned another expat in San José.

"Costa Rica has excellent medical care with a two prong system, both public and private. All legal residents and citizens of Costa Rica are eligible to participate in the public healthcare system which is basically free although you have to be a member of the CAJA and pay a % based on the income level you declared when you applied for residency. A tip for expats is to show evidence of enough income to qualify for their residency programs but perhaps not to show all your income if not needed to qualify. (You have to show proof of a pension, annuity or government program that pays you at least $1000 per couple to qualify for their pensionado program). If you don't qualify by those means, you can also apply as a rentista, (renter), an inversionista (an investor) or as a foreign sponsored national with a work visa. You can also marry a Costa Rican... Keep in mind that there is also a private healthcare network available, which is often the preferred option to many expats. There is often a waiting time to get seen under the public system, even things like lab work might take longer than you want to wait. The private healthcare system is generally available immediately and insurance can be purchased to cover you in those facilities. You can also often offer to pay at the CAJA and be seen quicker than those not paying for service. In an emegency, the CAJA will take anyone. Costa Rica uses a local clinic methodology where they locate clinics nearly everywhere based on population needs. These clinics are referred to as the EBAIS clinics and can be found in nearly every town of any size. Major operations, whether in the public or private healthcare system, will likely be performed in San Jose. The private healthcare networks consisting of Clinica Biblica, CIMA and Hospital Mexico, offer great service for a fraction of the cost in the US. Clinica Biblica has an international medicine center, assigns patients a health navigator to help with things like language barriers and offers services that may not even be available in the states. I have had nothing but great experiences there, everything from blood work, orthapedics, dentistry, colonoscopy, endoscopy, stress test and EKG, bone density scans, lipids exams, urinalysis, hearing and eye tests, ultrasounds and more. I have stuff done that I could never afford to do in the states and pay a fraction of the cost I would in the US. The facilities are all impeccably clean and the doctors don't seem to be afraid of their patients and lawsuits. In our area in the southern Pacific region of Costa Rica, we have one of the newest CAJA hospitals in all of Costa Rica. The Hospital de Osa is an 88 bed, 80,000 square foot facility complete with emergency room, pharmacy and more. I recommend everyone should try the Costa Rican healthcare system to see what we are missing in the US," commented one expat who moved to Cortez, Costa Rica.

"National health care may not provide a sufficient safety net - it may require a long wait for medical procedures. Private health care is recommended, but coverage for "pre-existing conditions" is generally not available except through national health care," remarked one expat living in Tamarindo.

"Residency to obtain public health care (CAJA) seems to be taking about 18 months, so you will have to use private care until you obtain residency (if that is what you plan on doing). Even with CAJA, many people continue to use the outstanding private facilities available in and around San Jose (possibly in other areas, but I am only familiar with San Jose). There are many expat health insurance plans available and I highly recommend obtaining one if you are under 70. There may be some available over 70; I don't know. I presently do not have any insurance and have been paying out of pocket for some serious medical issues. I suggest you have a fund of $6-10,000 tucked away if you don't have private insurance or have a high deductible," commented another person.

"I moved here in the middle of a 5 year treatment plan. I retired early, and had no medical insurance. To stay on my treatment, I was able to buy the medication OTC for $60 a month," mentioned another expat living in Florencia.

"In addition to general practice physicians, dentistry services and physical well being facilities, the area offers specialized care physicians who attend to the area residents. Local general care physicians offer the use of their offices for this specialized service such as women's health care, cardiology, dermatology, advanced dentistry and internal medicine," said an expat in Playa Jaco.

"Still working on the local insurance. Today I go out of pocket. Still less expensive than US," commented one expat living in Nosara, Costa Rica, Costa Rica.

"Medical and dental care are easily obtained, efficient, professional and relatively inexpensive here," added another expat.

"We currently don't have healthcare insurance in Costa Rica, so we pay out of pocket for doctors and prescriptions. It is less than we were paying for deductibles in the United States. I have Medicare/Medicaid and would fly home for treatment, if needbe. However, we have applied for residency in C.R. and will be fully covered once we're approved," commented one expat who moved to Sarchi.

"The caja is randomly assigned and not really a great value for what you get, private care is better and expat insurance isn't inexpensive. I do better to have my home health insurance and pay cash for services in CR however the providers here are excellent," said another expat.

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William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

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Are healthcare and health insurance expensive in Costa Rica?

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William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

William Russell Health Insurance

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

Learn MoreGET A QUOTE

William Russell Health Insurance

William Russell's private medical insurance will cover you and your family wherever you may be. Whether you need primary care or complex surgery, you'll have access to the best hospitals & doctors available. Unlike some insurers, we also include medical evacuation and mental health cover in our plans (except SilverLite). Get a quote from our partner, William Russell.

Learn MoreGET A QUOTE

About the Author

Joshua Wood Joshua Wood, LPC joined Expat Exchange in 2000. Joshua has a BA from Syracuse and a Master's in Clinical and Counseling Psychology from Fairleigh Dickinson University. Some of Joshua's more popular articles include Pros and Cons of Living in Portugal, 8 Best Places to Live in Croatia and the Living in Mexico Guide. Connect with Joshua on LinkedIn.

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